HBeAg阴性的慢性乙肝患者血清中LHBs与HBV-DNA水平的关系

The correlation between serum hepatitis B virus large surface protein and HBV-DNA level in chronic hepatitis B patients with HBeAg-negative

目的:探讨低水平HBV-DNA乙肝患者乙肝病毒外膜大蛋白(hepatitis B virus large surface protein,LHBs)的表达及其意义,从而探讨LHBs是否可以用作乙型肝炎e抗原(hepatitis B e antigen,HBeAg)阴性乙型肝炎患者病毒复制程度的判定指标。方法:对83例HBeAg阴性的慢性乙型肝炎患者血清,采用ELISA进行LHBs检测,全自动免疫分析仪检测HBeAg,实时荧光定量PCR方法检测HBV DNA。分析HBV DNA无拷贝数组、低拷贝数组及高拷贝数组中LHBs的检出率以及HBV DNA不同拷贝数组与LHBs的相关性。结果:在HBV DNA无拷贝数组,LHBs的阳性率为6.38%;低拷贝数组,LHBs的阳性率为56.25%,吸光度值与拷贝数对数值没有显著的相关性(r=0.25,P=0.36);高拷贝数组,阳性率为95%,吸光度值与拷贝数对数值有良好相关性(r=0.90,P<0.0001)。结论:检测HBeAg阴性慢性乙型肝炎患者血清LHBs,有助于判断患者体内HBV的复制程度,但是否能够作为HBeAg阴性乙型肝炎抗病毒治疗终点的有效判定指标,尚有待进一步探讨。

Objective： To investigate the correlation between the virus load and hepatitis B virus large surface protein（LHBs）in serum from chronic hepatitis B patients with e antigen negative,so as to evaluate whether LHBs can be used as a marker to determine the replication extent of hepatitis B virus in patients with negative hepatitis B e antigen（HbeAg）.Methods： Sera from 83 chronic hepatitis B patients with HBeAg negative were collected.LHBs level was detected by ELISA,with HBeAg tested by automatic immune analyzer and HBV DNA analyzed by real-time fluorescent quantitative PCR method.The correlation between the detection rates of LHBs in three groups（HBV DNA no-copy group,low-copy group and high-copy group） and the copy number of HBV DNA was analyzed.Results： In HBV DNA no-copy group,the positive rate of LHBs was 6.38%;in low-copy group,the positive rate was 56.25%,and the logarithm of copy number didn＇t have statistical correlation with the absorbance values of LHBs in those two groups（r = 0.25,P = 0.36）;in high-copy group,the positive rate was 56.25%,and there was significant correlation between the logarithm of copy number and the absorbance value of LHBs（r = 0.90,P 0.0001）.Conclusion： The detection of LHBs in chronic hepatitis B patients with HBeAg-negative contributes to evaluate the replication extent of HBV in patients.However,whether it can be used as an effective marker to guide the antiviral therapy of HBeAg-negative patients remains to be further studied.